Are You at Risk for Heart Disease?

Cardiovascular disease death rates may increase with presence of five risk factors

(RxWiki News) Heart disease remains the leading cause of death in the US, but watching for certain risk factors may help give your heart a chance.

A new study found that five preventable risk factors accounted for almost half of all heart disease deaths between 2009 and 2010.

"Modifiable cardiovascular-related risk factors (such as elevated cholesterol levels, diabetes, hypertension, obesity, and smoking) are responsible for much of the national burden of cardiovascular disease mortality," wrote lead study author Shivani A. Patel, PhD, of the Rollins School of Public Health at Emory University in Atlanta, GA, and colleagues.

Josephine Dlugopolski-Gach, MD, a board-certified internal medicine and pediatrics physician with Loyola University Health System, told dailyRx News that "We are all creatures of habit, it is difficult to change a pattern that has been repeated for 20 to 40 years. Many of my patients truly believe that they are eating healthy because everyone in their life eats the same way."

Dr. Dlugopolski-Gach added that her patients who are most successful at changing their lives to benefit their heart health "make small changes that they can stick with. Often times people change their whole world in one week and give up very quickly since it is impossible for them to maintain. I tell some of my patients to give up soda this week and if the change is tolerable give up soda and potato chips the following week and so on. The third week, add some light exercise and escalate. By the end of a few months, they have made a lot of changes and are more likely to stick with it because it was gradual and not shocking."

For this study, Dr. Patel and team looked at more than 530,000 patients who responded to a heart disease risk study between 2009 and 2010. All of the patients were between 45 and 79 years old.

These patients were asked if they had any of five risk factors for heart disease: high cholesterol, diabetes, hypertension (high blood pressure), obesity or whether they smoked. Dr. Patel and team found that most of the patients (around 80 percent) had at least one risk factor.

Hypertension was defined as having a blood pressure reading higher than a normal reading of around 120 over 80 millimeters of mercury (mm Hg).

Obesity was defined as having a body mass index (BMI) over 30. BMI is a measure of body fat based on height and weight. A BMI between 18 and 25 is considered normal.

Diabetes was defined as having type 2 diabetes. Patients with type 2 diabetes do not make or use insulin well. Insulin is a hormone that helps blood glucose (blood sugar) reach the body's cells to give them energy. Obesity is thought to be the most common cause of type 2 diabetes.

According to the World Heart Federation, there are many risk factors associated with heart disease. Some factors cannot be changed, such as family history, ethnicity and age. Other risk factors may be modifiable, such as tobacco exposure, obesity, type 2 diabetes, unhealthy diets and alcohol abuse.

According to Dr. Patel and team, about half of US heart disease deaths that occurred between 2009 and 2010 could have been prevented if all five of these risk factors were eliminated.

Therefore, the prevalence of each risk factor in the US was used to assess whether the prevention of these risks could reduce the resulting possible number of heart disease deaths.

According to Dr. Patel and team, within each state and nationally, this type of comparative assessment of preventable heart disease mortality is important to the evaluation of health care policy.

While about half of heart disease deaths could be prevented if all of these risk factors were completely eliminated, Dr. Patel and team found that less than 10 percent of heart disease deaths could be prevented if all states were to achieve risk factor levels observed in the best-performing states.

The authors concluded that all states could benefit from more aggressive policies and programs to help curb the risk of death from heart disease.

"All states can benefit from further risk reduction," Dr. Patel and colleagues wrote. "These risk factors are highly correlated across states and are modifiable through policies that can influence multiple risk factors simultaneously (for example, tobacco taxation, smoke-free places, and construction of built environments that promote physical activity)."

This study was published online June 29 in the journal Annals of Internal Medicine.

The Robert Wood Johnson Foundation funded this research. No conflicts of interest were disclosed.

Review Date: 
June 29, 2015